Liver cancer, also known as hepatocellular cancer (HCC), arises from hepatocytes (liver cells). HCC often develops only in liver that is severely damaged by longstanding diseases or chemicals. The liver becomes hardened and shrunken – a condition called liver cirrhosis.
The liver can also be subjected to another form of cancer, called secondary or metastatic cancer. The main cancer forms elsewhere in the body and secondary deposits are formed in the liver. A common example is colorectal cancer spreading to the liver via the bloodstream.
How common is Liver Cancer
Liver Cancer is common in South East Asia, including Singapore. This is due to the presence of chronic hepatitis B and C infection in the population. In Singapore, liver cancer is the 4th most common cancer. It is more common in males and among the Chinese population.
Risk Factors
The risk factors of HCC are similar to those for liver cirrhosis:
* Chronic infection with Hepatitis B and C viruses
* Excessive consumption of alcohol
* Aflatoxin, a poisonous substance produced by a fungus found in mouldy peanuts and grains
* Chemicals such as nitrites, hydrocarbons, solvents, vinyl chloride are known carcinogens linked to HCC
* Inherited conditions which cause liver cirrhosis, such as haemachromatosis, Wilson’s disease
Signs & Symptoms
These usually do not show up until the later stages:
* One of the most common presentations is loss of appetite, loss of weight and tiredness
* When the cancer is big, the patient may note a persistent pain or a lump in his upper right abdomen
* Increase in the abdomen girth
* Jaundice
* Dramatic change in the overall condition of a person with chronic hepatitis or cirrhosis
Prevention
* Vaccinate against hepatitis B virus. In Singapore, all newborns are vaccinated
* Avoid contact with known liver carcinogens, especially alcohol
* Avoid heavy meat and animal fat intake. Avoid mouldy peanuts and grains
* Go for regular screening if you are in the high risk group
Treatments
There are various treatments available to sufferers of HCC. These include:
* Surgery. It involves removing one lobe of the liver (hepatectomy). This is a major operation with small risk of complications and death.
* Chemotherapy. Uses toxic drugs to kill the cancer.
* Radiation treatment. Combined with chemotherapy, it offers some benefits in inoperable HCC.
* Newer treatments. Use of cryosurgery, ethanol injection, high energy waves to destroy the HCC. Another method is the introduction of a plastic tube into the hepatic artery for the purpose of injecting substances to kill the cancer or stop its blood supply. At present, such treatment is used in the palliation of inoperable HCC.